STEPHEN MATTHEW BROADDUS Athletic Trainer License verification

Business Entity

INACTIVE

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096002618

License Status

INACTIVE

Business

First Name

STEPHEN

Middle

MATTHEW

Last Name

BROADDUS

Business Name

STEPHEN MATTHEW BROADDUS

Original Issue Date

06/19/2008

Effective Date

05/05/2010

Expiration Date

05/31/2012

City

TROY

State

Zip

62294

County

MADISON

Ever Disciplined

LastModifiedDate

03/08/2012